Correlation Between the Overactive Bladder Questionnaire (OAB-q) and Urodynamic Data of Parkinson Disease Patients Affected by Neurogenic Detrusor Overactivity During Antimuscarinic Treatment

Palleschi, Giovanni; Pastore, Antonio Luigi; Stocchi, Fabrizio; Bova, G.; Inghilleri, Maurizio; Sigala, Sandra; Carbone, Antonio

doi:10.1097/01.wnf.0000228177.75711.0f

Cited by 25 publications

(11 citation statements)

References 30 publications

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“…Therefore, results of urodynamics may be somehow misleading and results should be interpreted with caution. In case of PD, it is known that the urodynamic finding of DO correlates very well with the results of questionnaires, and the latter may be useful for evaluation of LUTS.…”

Section: Discussionmentioning

confidence: 94%

Does deep brain stimulation improve lower urinary tract symptoms in Parkinson's disease?

Witte

Odekerken

Boel

et al. 2017

Neurourology and Urodynamics

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Aims: To investigate whether deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) or the subthalamic nucleus (STN) improve lower urinary tract symptoms (LUTS) in advanced Parkinson's disease (PD). Methods: An exploratory post-hoc analysis was performed of specific LUTS items of questionnaires used in a randomized clinical trial with 128 patients (NSTAPS study).First, we compared scores on LUTS items at baseline and 12 months for the GPi DBS and STN DBS group separately. Second, we divided the group by sex, instead of DBS location; to assess a possible gender associated influence of anatomical and pathophysiological differences, again comparing scores at baseline and 12 months. Third, we reported on Foley-catheter use at baseline and after 12 months. Results: Urinary incontinence and frequency improved after both GPi DBS and STN DBS at 12 months, postoperatively, but this was only statistically significant for the STN DBS group (P = 0.004). The improvements after DBS were present in both men (P = 0.01) and women (P = 0.05). Nocturia and urinary incontinence did not improve significantly after any type of DBS, irrespective of sex. At 12 months, none of the patients had a Foley-catheter. Conclusions: Urinary incontinence and frequency significantly improved after STN DBS treatment in male and female patients with PD. Nocturia and nighttime incontinence due to parkinsonism did not improve after DBS, irrespective of gender.

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Section: Discussionmentioning

confidence: 94%

Does deep brain stimulation improve lower urinary tract symptoms in Parkinson's disease?

Witte

Odekerken

Boel

et al. 2017

Neurourology and Urodynamics

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“…The storage‐phase urodynamic abnormalities in PD include reduced bladder capacity together with DO in 45–93% of patients, which is well correlated with the questionnaire, and uninhibited external sphincter relaxation in 33% of patients. Therefore, DO can be the major contributing factor to overactive bladder in PD.…”

Section: Bladder Function Of Patients With Pdmentioning

confidence: 86%

Bladder function of patients withParkinson's disease

et al. 2014

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Abbreviations & Acronyms A = adrenergic/noradrenergic BBB = blood-brain barrier DA = dopamine DLTN = dorsolateral tegmental nucleus DO = detrusor overactivity GABA = gamma-amino-butyric acid Glu = glutamate. GPi = globus pallidus internus IML = intermediolateral cell column L = lumbar LC = locus ceruleus LUT = lower urinary tract LUTS = lower urinary tract symptoms MPOA = medial preoptic area MSA = multiple system atrophy NBM = nucleus basalis Meynert OAB = overactive bladder PAG = periaqueductal gray matter PBN = parabrachial nucleus PD = Parkinson's disease PMC = pontine micturition center PVN = paraventricular nucleus S = sacral SNc = substantia nigra pars compacta SNr = substantia nigra pars reticulata STN = subthalamic nucleus T = thoracic TUR-P = transurethral prostate resection of the prostate VTA = ventral tegmental area ZI = zona incerta Abstract: Bladder function of patients with Parkinson's disease alters significantly: the majority of patients have overactive bladder (urinary urgency/frequency) with little or no post-void residuals. This seems to be the result of an altered brain-bladder relationship, as in Parkinson's disease, the frontal-basal ganglia D1 dopaminergic circuit that normally suppresses the micturition reflex is altered. The pathophysiology of the bladder dysfunction in Parkinson's disease differs from that in multiple system atrophy; therefore, it might also aid in differential diagnosis. The effects of levodopa, the major drug to treat motor dysfunction, on the bladder in Parkinson's disease vary significantly; therefore, add-on therapy is often required. Anticholinergic drugs are the first-line treatment, with particular care for cognitive function in elderly patients. The second-line treatment includes serotonergics drug, desmopressin and others. Newer modalities include deep brain stimulation that improves the bladder in Parkinson's disease; and botulinum toxin is promising, particularly in difficult cases. These treatments might be beneficial in maximizing the patients' quality of life.

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“…Bladder hyperactivity includes irritative urinary symptoms 11,12 , increase in daytime urinary frequency, nocturia, and urgency with or without urge incontinence 13,14 . Such symptoms usually become more pronounced in PD due to the bradykinesia, thus leading to a decrease in patients' quality of life 15 . PD patients with lower urinary tract symptoms require urodynamic evaluation to establish the neurologic origin of the urinary dysfunctions 16 .…”

Section: Results Baselinementioning

confidence: 99%

Urinary dysfunction with detrusor hyperactivity in women with Parkinson's disease cannot be blamed as a factor of worsening motor performance

Campos-Sousa

Quagliato

Almeida

et al. 2013

Arq. Neuro-Psiquiatr.

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Introduction: Detrusor hyperactivity is the leading cause of urinary dysfunction in Parkinson's disease (PD). There are few studies correlating PD clinical aspects with this autonomic feature. Methods: A cohort of 63 women with PD were prospectively examined for assessment of clinical aspects and disease severity using unified Parkinson's disease rating scale and Hoehn-Yahr scale, respectively. The urologic function was evaluated by the urodynamic study. Two groups were categorized at this time -groups with and without detrusor hyperactivity. After seven years, the same parameters were re-evaluated. Results: Progression of the disease on mental scores was found in the group with detrusor hyperactivity. On follow-up, clinical symptoms and severity did not show significant worsening between the groups. Conclusion:Detrusor hyperactivity is a frequent urodynamic finding in PD, and even though it is associated with dopaminergic dysfunction, it cannot be blamed as a factor of worsening motor performance, but is probably associated with poor cognitive and mental prognosis.Key words: detrusor overactivity, detrusor hyperreflexia, Parkinson's disease, urinary symptoms. rEsUMO Introdução: Hiperatividade detrusora (HD) é a principal causa de disfunção urinária na doença de Parkinson e poucos estudos correlacionam aspectos clínicos da doença com este componente autonômico. Métodos: Foi avaliada uma coorte de 63 pacientes com DP quanto aos aspectos clínicos e gravidade global da doença utilizando as escalas UPDRS e Hoehn-Yahr. A função urológica foi avaliada através de estudo urodinâmico. Foram então categorizados dois grupos: pacientes com e sem HD. Após sete anos os mesmos parâmetros foram reavaliados.Resultados: Houve progressão da doença quanto aos escores mentais no grupo com HD. Na reavaliação dos grupos os sintomas motores não evidenciaram piora significante. Conclusão: HD é um achado urodinâmico frequente em pacientes com DP. Embora associada à disfunção dopaminérgica, HD não pode ser considerada fator de risco para piora do desempenho motor, mas provavelmente está associada com pior prognóstico mental e cognitivo.Palavras-Chave: hiperatividade detrusora, hiperreflexia detrusora, doença de Parkinson, sintomas urinários. Urinary dysfunction with detrusor hyperactivity in women withParkinson's disease cannot be blamed as a factor of worsening motor performance Disfunção urinária com hiperatividade detrusora não é fator de risco para progressão do desempenho motor em mulheres com doença de Parkinson

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Correlation Between the Overactive Bladder Questionnaire (OAB-q) and Urodynamic Data of Parkinson Disease Patients Affected by Neurogenic Detrusor Overactivity During Antimuscarinic Treatment

Cited by 25 publications

References 30 publications

Does deep brain stimulation improve lower urinary tract symptoms in Parkinson's disease?

Does deep brain stimulation improve lower urinary tract symptoms in Parkinson's disease?

Bladder function of patients withParkinson's disease

Urinary dysfunction with detrusor hyperactivity in women with Parkinson's disease cannot be blamed as a factor of worsening motor performance

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